Kathleen S. Boyd, DDS, MS

Cracked Teeth

With the advancements in modern medicine, people are living longer, thus exposing their teeth to more years of chewing, clenching and grinding. Cracks and fractures are becoming more common, but unfortunately these cracks do not show up well on X-rays, making them harder to discover. Typical symptoms of a cracked tooth include pain while chewing, sensitivity to hot and cold temperatures or release of biting pressure.

All cracked teeth do not hurt, but there are many reasons why one does. When chewing, the cracked or broken part of the tooth moves separately from the tooth, and this agitates the tooth’s pulp. The pulp tissue can also be damaged because of the depth of the crack, causing the tooth to constantly hurt. Pain can also be a result of the tooth coming in contact with hot or cold foods and beverages.

A cracked tooth can be saved and repaired, but it depends on the depth of the crack. Repairs includes anything from a restoration or crown being placed to a root canal procedure coupled with the placement of a crown.

Types of Tooth Fractures

Crazelines: Most common in adult patients, these cracks are on the outer enamel of the tooth. They generally only treated for aesthetic purposed.

Fractured Cusps: If a cusp, or “corner,” of a tooth is weakened, it can crack the tooth. The cusp may break off or it may need to be removed. If the fracture is deep enough, the pulp may become damaged and a root canal is necessary. Usually a crown is used to fix this fracture.

Cracked Tooth: This fracture usually spans from the chewing surface, toward the root, and sometime below the gum. The damaged tooth pulp will need to be fixed by endodontic therapy, and a replacement crown is usually placed.

Split Tooth: If a cracked tooth isn’t fixed, a split tooth results. The tooth becomes split in two pieces, and unfortunately cannot be saved. Endodontic treatment will need to be performed on a split tooth.

Vertical Root Fractures: This fracture starts in the tooth root and travels upward toward the chewing surface. These fractures are hard to catch because they generally have no associated symptoms. Usually caused by trauma, endodontic treatment is necessary.